How to Insert the Estring Vaginal Ring
Wash and dry your hands before handling the ring. Choose a comfortable position, like lying on your back with knees bent, squatting, or standing with one leg raised. Squeeze the ring between your thumb and index finger into a folded shape. Gently insert it into the vagina as far as it will comfortably go, using the same motion as inserting a tampon—it doesn't need to reach a specific spot inside.[1]
How to Remove the Estring Vaginal Ring
Wash hands first. Put a finger into the vagina and hook the ring's edge. Gently pull it out. Place it in the foil pouch and dispose of it in the trash—do not flush. The ring is used continuously for 90 days before replacement.[1]
Replacement Schedule
Replace with a new ring every 3 months (90 days). Remove the old one, insert the new one on the same day, and keep it in place continuously, even during sex or menstruation. If it falls out, rinse with warm water and reinsert promptly.[1]
What If the Ring Comes Out or Is Hard to Find?
Rinse the ring with warm water if it expels (this can happen during bowel movements or sex) and reinsert it. If you can't find it or it's been out longer than 3 hours, use backup contraception like condoms for 7 days and contact your doctor. Report prolonged loss to your prescriber.[1]
Common Mistakes and Tips
Do not use tampons, as they can pull the ring out. Lubricants are usually fine but check with your doctor for compatibility. If you feel discomfort or suspect incorrect placement, remove and reinsert or see a healthcare provider. Estring releases low-dose estradiol locally for menopause symptoms like vaginal dryness—it's prescription-only.[1]
Side Effects Patients Report
Local irritation, vaginal discharge, or infection risk. Systemic effects like breast tenderness or headaches occur less often due to low absorption. Stop use and seek medical help for severe abdominal pain, chest pain, or vision changes, which could signal blood clots. Discuss risks with your doctor if you have a history of hormone-sensitive cancers or clotting disorders.[1][2]
[1] https://www.estring.com/hcp/dosing-administration
[2] https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020813s019lbl.pdf